【注意：本文章及真實病人照片均源自鍾經略醫生的臨床皮膚科碩士及美容醫學碩士課程案例，屬於原創醫學文獻。因此，本院嚴格保留所有版權。同時，我們禁止任何形式的轉載與複製。】
一粒位於左邊上眼皮的深啡色，凸出的墨痣. A medium sized dark brown mole situates on the left upper eyelid.
一粒位於左邊上眼皮的深啡色，凸出的墨痣. A medium sized dark brown mole situates on the left upper eyelid.
激光脫墨後留下一個下陷的傷口. After co2 laser removal, there is a depressed wound
鍾醫生有對大型傷口處理的經驗，並經過他的特別謹慎的處理，傷口恢復的幾乎不見疤痕 After Dr Chung King Lueh’s treatment for deep wounds, the wound heals up quick and leaves minimal scar
請參考網站內其他章節，了解鍾醫生對傷口處理嘅見解同方法。
這是二氧化碳激光氣化上眼皮凸痣（凸墨）的手術前後對比圖
This is a before and after picture of co2 laser mole removal on the upper eyelid
Discussion: Advantages of CO₂ laser mole removal on the upper eyelid compared to traditional surgical excision
Introduction
Benign mole removal in the periocular region presents unique challenges. The upper eyelid is cosmetically sensitive and functionally critical. Scarring, slow healing, or tissue disruption here quickly damages both appearance and eyelid function.
Surgeons traditionally rely on standard surgical excision. However, CO₂ laser ablation delivers clearer advantages. Specifically, it accelerates healing, improves cosmetic outcomes, enhances safety, and increases patient comfort.
1. Faster Healing
- CO₂ Laser: Produces precise ablation with minimal collateral damage. Reduced bleeding and tissue trauma accelerate epithelialization and shorten recovery time.
- Surgical Excision: Requires incision and suturing, which prolongs healing due to wound tension and suture‑related inflammation.
2. Superior Cosmetic Results
- CO₂ Laser: Leaves a smooth surface with minimal scarring. Scars are often faint and blend with natural eyelid folds, preserving aesthetic harmony.
- Surgical Excision: Linear scars may be more visible, especially if not aligned with natural creases.
3. Enhanced Safety in the Eyelid Area
- CO₂ Laser: Minimizes bleeding, reduces hematoma risk, and allows precise targeting without deep tissue disruption. Corneal shields can be used to protect the eye.
- Surgical Excision: Requires careful dissection and suturing near delicate structures, with higher risk of inadvertent tissue damage.
4. Easier Wound Management
- CO₂ Laser: Postoperative care is simple—usually limited to topical ointment and gentle cleansing. No sutures are required, reducing discomfort and follow‑up visits.
- Surgical Excision: Demands suture care, possible removal, and more intensive wound monitoring.
5. Better Hair Preservation
- CO₂ Laser: Can selectively ablate mole tissue while sparing adjacent hair follicles. In many cases, even hairs within the mole can be preserved with careful technique.
- Surgical Excision: Follicles within the excision margin may be sacrificed, leading to localized hair loss.
6. Shorter Operation Time
- CO₂ Laser: Quick ablation without suturing significantly reduces procedure time. This is particularly beneficial for paediatric patients who may struggle with prolonged procedures.
- Surgical Excision: Longer due to incision, dissection, and layered closure.
7. High Clearance Rate
- CO₂ Laser: Allows direct visualization of the mole’s root, which appears distinct from surrounding normal tissue. This enables complete ablation while minimizing collateral damage. However, it requires extensive training and considerable experience to master.
- Surgical Excision: Provides histological confirmation of complete removal but may involve excising more tissue than necessary.
Conclusion
First, the laser seals small blood vessels immediately. As a result, patients experience less tissue trauma and recover faster. In addition, surgeons target the mole with precision, which yields superior cosmetic outcomes.
Furthermore, controlled laser depth makes periocular application safer around the eye. Sealed skin edges also eliminate sutures, so patients manage simpler wound care.
Finally, practitioners direct the beam carefully to ensure better hair preservation for nearby lashes and brows. Overall, the quick process requires minimal setup, so surgeons achieve shorter operation times.
With careful observation of the mole’s root, clearance rates remain high.
Surgeons still rely on surgical excision when they need histological confirmation. However, in cosmetically sensitive areas like the eyelid, CO₂ laser ablation is often the better choice. Ultimately, this approach strikes an ideal balance between medical safety and aesthetic excellence.
專題討論：眉毛上方良性痣切除 —— 二氧化碳激光相較於傳統外科切除的優勢
1. 癒合更快
- 激光：能夠精準、可控地消融痣組織，對周圍組織的損傷極小。減少出血與組織破壞，促進更快的上皮化。
- 外科：需切開並縫合，因傷口張力及縫線相關炎症，癒合時間較長。
2. 美容效果更佳
- 激光：表面更平滑，疤痕較少，尤其在眼瞼等美容敏感區域更為重要。疤痕通常較淡，甚至可與自然皮膚皺褶融合。
- 外科：線狀疤痕可能更明顯，特別是未能與自然皺褶對齊時。
3. 眼瞼區域的安全性提升
- 激光：減少出血，降低血腫風險，並能精準定位而不破壞深層組織。可使用角膜保護片以保障眼睛安全。
- 外科：需在精細結構附近小心剝離與縫合，若操作不慎，損傷周邊組織的風險較高。手術中也常需角膜保護片以防意外損傷。
4. 傷口護理更簡便
- 激光：通常僅需局部護理（抗生素藥膏、溫和清潔）。無需拆線，減少病人不適與隨訪次數。
- 外科：需縫線護理，可能需要拆線，傷口監測更為繁瑣。
5. 毛髮保存更好
- 激光：可選擇性消融痣組織，同時保留周邊毛囊，維持眉毛或睫毛完整。在許多情況下，甚至痣內的毛髮也能保存，若採用合適技術。
- 外科：若毛囊位於切除邊界，可能被犧牲，導致局部脫毛。
6. 手術時間更短
- 激光：快速消融且無需縫合，大幅縮短手術時間。對於難以耐受長時間操作的兒科病人尤為重要。
- 外科：因需切開、剝離及分層縫合，手術時間較長。
7. 高清除率
- 激光：能直接觀察痣的根部，其外觀與周圍正常組織不同，便於徹底消融並減少附帶損傷。但此技術需長期訓練與豐富經驗才能掌握。
- 外科：可透過病理檢查確認完全切除，但可能會切除過多正常組織。
總結
眉毛附近的激光痣切除能提供更快癒合、更佳美容效果、更簡便的傷口護理、更好的毛髮保存以及更短的手術時間，同時在仔細觀察痣根部時仍能達到高清除率。外科切除在需要病理學確認時仍具價值，但在美容敏感區域如眉毛，二氧化碳激光消融往往是更理想的選擇。